title: [CSF leakage and anosmia in aneurysm clipping of anterior communicating artery by basal interhemispheric approach].
abstract: We studied the incidence of postoperative infection related to CSF leakage and anosmia in basal interhemispheric approach (BIH). Between April, 1990 to March, 2009, 142 cases of anterior communicating (Acom) aneurysm including both unruptured and ruptured have been treated by clipping surgery using BIH. We retrospectively obtained clinical informations from medical records and video records about infectious complications, CSF leakage of cerebrospinal fluid (CSF), olfactory dysfunction and intraoperative findings of damage to the olfactory nerve. In most cases (139 patients, 97%), frontal sinus were opened at craniotomy. Of all, CSF rinorrhea occurred in 4 cases (2.8%), and meningitis in 6 cases. There was only one patient who sufferd from meningitis due to CSF rinorrhea. All that patients recovered completely without deficit. Anosmia occurred in 6 cases (4.2%), and intraoperative injuries in 4 cases (2.8%). There was only one patient in whom anosmia was consistent with nerve injury. In conclusion, BIH is an appropriate procedure for infection risk control in Acom aneurysm surgery. It is difficult to avoid olfactory dysfunction completely, even if olfactory nerves are preserved in form.
authors.affiliation: Department of Surgical Neurology, Research Institute for Brain and Blood Vessels Akita, Japan.
authors.forename: Hirobumi
authors.initials: H
authors.lastname: Nakayama
authors.forename: Tastuya
authors.initials: T
authors.lastname: Ishikawa
authors.forename: Shingo
authors.initials: S
authors.lastname: Yamashita
authors.forename: Issei
authors.initials: I
authors.lastname: Fukui
authors.forename: Tatsushi
authors.initials: T
authors.lastname: Mutoh
authors.forename: Kentaro
authors.initials: K
authors.lastname: Hikichi
authors.forename: Shotaro
authors.initials: S
authors.lastname: Yoshioka
authors.forename: Hideya
authors.initials: H
authors.lastname: Kawai
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Tamakawa
authors.forename: Junta
authors.initials: J
authors.lastname: Moroi
authors.forename: Akifumi
authors.initials: A
authors.lastname: Suzuki
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Yasui
mesh_terms: D000328:Adult; D000368:Aged; D017542:Aneurysm, Ruptured / Q000601:surgery; D020771:Anterior Cerebral Artery / Q000601:surgery; D002559:Cerebrospinal Fluid Rhinorrhea / Q000209:etiology*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D000857:Olfaction Disorders / Q000209:etiology*; D061219:Olfactory Nerve Injuries; D011183:Postoperative Complications; D012189:Retrospective Studies